TOPLINE

A brief GP-led narrative exposure therapy for ICU survivors with posttraumatic stress disorder (PTSD) symptoms was associated with meaningful improvements in health-related quality of life (HRQOL).

METHODOLOGY

• Researchers performed a secondary analysis of a multicentre, randomised controlled trial (PICTURE) conducted across primary care practices in Germany between 2018 and 2022 to evaluate HRQOL outcomes.
• They included 319 adult ICU survivors (mean age, 57.7 years; 60.8% men) of a significant critical illness who experienced at least moderate PTSD symptoms at enrolment.
• Patient-GP pairs were randomly assigned to either an intervention group, in which a short structured course of narrative exposure therapy was delivered directly by the GP across three sessions over roughly 6 weeks, or a control group that received enhanced usual care on the basis of existing PTSD treatment guidelines across three consultations.
• In the intervention group, an adapted narrative exposure therapy protocol was followed, which integrated a traumatic critical illness event into the patient's memory, and nurses handled case management and care coordination.
• HRQOL was assessed using the EuroQol (EQ) Five-Dimension Five-Level questionnaire that covered five dimensions (mobility, self-care, pain/discomfort, usual activities, and anxiety/depression), yielding an index (EQ index) score and a visual analog scale (EQ VAS) score, both assessed at baseline and 6 and 12 months.

TAKEAWAY

• For overall HRQOL measured using the EQ index, no clear effect was observed at 6 months; however, an improvement was seen by 12 months (beta-coefficient, 0.075; 95% CI, 0.014-0.136).
• A short-term improvement was noted in EQ VAS scores at 6 months, reflecting the participant's own rating of overall health (beta-coefficient, 5.85; 95% CI, 0.84-10.87), but this benefit was not maintained at 12 months.
• Among individual domains, anxiety and depression reduced at both 6 months (beta-coefficient, -0.28; 95% CI, -0.56 to -0.01) and 12 months (beta-coefficient, -0.34; 95% CI, -0.63 to -0.05), and mobility improved at 12 months.

IN PRACTICE

"[The intervention's] brief, manualised format and limited training requirements make it suitable for primary care," the authors of the study wrote.

SOURCE

The study was led by Robert Philipp Kosilek, Institute of General Practice and Family Medicine, LMU University Hospital, LMU Munich, Munich, Germany. It was published online on July 21, 2026, in the European Journal of General Practice.

LIMITATIONS

HRQOL was a secondary outcome of the trial, and the trial was not powered to detect small differences in questionnaire scores. The mediation analysis was observational and could not establish cause-and-effect relationships. The self-reported mental health measures may have introduced reporting bias.

DISCLOSURES

The study received funding from the German Research Foundation (Deutsche Forschungsgemeinschaft). The authors reported having no conflicts of interest.

This article was created using several editorial tools, including AI, as part of the process. Human editors reviewed this content before publication.